Johnson & Johnson Notes on NursingNurses Leading Innovation

5 Nurses Making Waves in Healthcare Innovation

From socks that monitor heart failure to a tool that aims to predict developmental outcomes in newborns, nurse innovators around the world are developing solutions with the potential to change human health. Meet five nurses who are transforming what it means to be on the frontlines of care.

Every day, nurses bring resourcefulness and deep patient experience to their roles, adapting to challenges and naturally identifying opportunities to improve patient care. Johnson & Johnson believes nurses are the backbone of our healthcare system and that they are uniquely positioned to create innovative solutions. That’s why we’ve launched the Johnson & Johnson Nurses Innovate QuickFire Challenge series, which expands the definition of what innovation means for frontline health workers by inviting nurses worldwide to develop and share their novel concepts, protocols, treatment approaches and device ideas that have the power to profoundly change human health.

The first Johnson & Johnson Nurses Innovate QuickFire Challenge launched in fall 2018 and the awardees, Lauren Wright, Ph.D. student, MSN, AGNP-BC, CEO and Founder at The Natural Nipple, and Abby Hess, APRN, DNP, nurse inventor at Cincinnati Children’s Hospital, were announced during National Nurses Week in May 2019. We were so inspired by the many submissions we received for our first Nurses Innovate QuickFire Challenge and wanted to connect with some of the finalists to learn more about the inspiration behind their great ideas, why nurses make great innovators and what’s next for their invention.

Barbara Medoff-Cooper, PhD, RN
Professor Emeritus at the University of Pennsylvania and Nurse Scientist at Children’s Hospital of Philadelphia
Developed Neoneur, a tool to assess the neurological development of newborns

J&J: What was the inspiration behind your invention?
Barbara: I really wanted to find a way to understand neurological changes in the neonate (newborn) without using an MRI. While the Neoneur is a tool to assess the neurological development of newborns, flagging those at-risk for developmental delays, we also found it aligned with today’s clinical needs by assessing and aiding safe and effective transitions for an at-risk infant to full oral feed. If their feeding tube is removed before the infant is ready to transition to full oral feed, they are at-risk clinically for respiratory distress and long-term oral aversion. This can also significantly increase length of stay and cases of readmission.

J&J: How does your invention aim to improve outcomes for families and healthcare systems?
Barbara: More and more at-risk and premature infants are surviving due to improvements in neonatal intensive care. Many of these infants will have long-term clinical complications, which can cost the US healthcare system over $26 billion a year. [1] Research has shown that early intervention can save around $190,000 in healthcare costs between the ages of 3 and 22. [2] When you look at that statistic, and the fact that less than 20% of autistic children are identified prior 2 years of age [3] , there is a huge opportunity to significantly reduce healthcare costs and improve the lives of families.

J&J: Why do you believe nurse-led innovation is important?
Barbara: In the NICU, clinical decisions are based on nurses’ observations. They see problems in real-time, the outcomes that develop both before and after discharge and are usually responsible for the follow-up care coordination. This enables them to identify solutions to clinical needs, just like the Neoneur. And the funny thing is, often these are really economical solutions.

Ernesto Holguin, RN, BSN, CNN, CEO of OTEN Medical
Dialysis Clinical Coordinator for Las Palmas Medical Center and Las Palmas Rehabilitation Center in El Paso, Texas
Invented DiFoBod, a diabetic foot management telehealth system

J&J: What inspired you to bring your invention forward?
Ernesto: I was inspired to develop DiFoBod in 2003 after witnessing the debilitating effect of diabetic foot ulcers (DFUs). My experience motivated me to find a way to prevent complications from DFUs and painful, sometimes fatal, health outcomes.

J&J: How will your invention help patients with diabetic foot ulcers?
Ernesto: Making sure that feet are dry in between the toes can help prevent skin breakdown and infections. Research shows there is a 40% recurrence rate of DFUs, which can result in reinfections, rehospitalizations, amputations and even death. [1] DiFoBod uses telehealth technology to allow patients to send daily thermal images to their physician. Identifying early ulcer formation may help with prevention and early medical intervention. DiFoBod also allows patients to monitor for DFUs in their own homes.

J&J: What’s next for you now?
Ernesto: I have learned that bringing my idea to life will come with many obstacles, a lot of time and failures, so I need a lot of determination. I am currently working with a company to refine the DiFoBod, applying for the Small Business Innovation Research (SBIR) program, becoming Historically Underutilized Business (HUB) Certified and getting in front of as many early-stage investors as I can. I am enjoying the startup business space and absorbing as much information as possible in order to reach my goal to help people with diabetes alleviate their daily burdens.

Charleen Solomon, CEO and Founder, and Janet Bunney, Retired RN, Vice President of Sales
Arise Healthcare Products in Oakdale, California
Created the Q2 Solution, a medical device that provides moving support to bedbound patients

J&J: What was the inspiration behind your invention?
Janet: Charleen's vision for the Q2 Solution came after working with a home care patient. Her back was on fire from working a double shift, lifting and moving patients alone. She used a sweatshirt to help hold her patient, then began looking for a product that could do this for her. There was no product available that would act as a turning, changing and incontinence device, while holding the patient in place and taking the weight off the caregiver's back and arms, so Charleen designed one herself.

J&J: How does your invention aim to improve health outcomes?
Charleen: The Q2 Solution was designed to reduce the rate of nurse injuries. By reducing worker's comp claims, there should be more staff available, increasing the ability to adhere to the Q2 Protocol, which requires patients to be turned every two hours to prevent pressure ulcers. The potential impact will ultimately be a reduction in litigation and hospitals absorbing the cost of "never events,” or preventable errors in medical care.

J&J: Do you have any advice for nurses with great ideas of their own?
Charleen: Develop your ideas! Don't let anyone dissuade you, stay the course and seek advice from professionals around you. If you can get involved in a startup incubator, that will help you monumentally. Enter competitions to demo your product and practice your pitch deck!

Pamela Z. Cacchione, PhD, CRNP, BC, FGSA, FAAN
Ralston House Term Chair in Gerontological Nursing, University of Pennsylvania School of Nursing Nurse Scientist, Penn Presbyterian Medical Center
Invented heart failure monitoring socks

J&J: What was the inspiration behind your invention?
Pamela: I have been a gerontological nurse practitioner for over 30 years and taken care of countless nursing home residents with heart failure. But when my brother developed heart failure in his 40s following surgery, I was at a loss. I could not get him to weigh himself. We finally started talking about marks from his socks, a symptom of peripheral edema, which gave me the idea to develop heart failure monitoring socks that would measure swelling, activity and possibly weight for people with heart failure, as these patients often have difficulty monitoring their own signs and symptoms.

J&J: Did you employ an interprofessional or cross-disciplinary approach to your idea?
Pamela: Without a doubt, an interdisciplinary approach was key. I worked with six engineering students to develop the first prototype. We worked with a cardiologist, a nursing symptom scientist and a data scientist to conceive the first prototype.

J&J: Do you have any advice for nurses with great ideas of their own?
Pamela: Yes, talk with people who may be able to help you. Share the support you need, not necessarily your whole idea. Reach out to collaborators and design for the extremes. Think about collaborators outside of healthcare. I love working with engineers! Enjoy the journey.

In collaboration with the Association of periOperative Registered Nurses (AORN), Johnson & Johnson recently announced the Nurses Innovate QuickFire Challenge in Perioperative Care, inviting nurses to submit their innovative ideas that aim to improve perioperative care and change human health. We also recently launched the Nurses Innovate QuickFire Challenge in Maternal and Newborn Health, together with the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN), inviting nurses to submit their ideas aiming to improve maternal and newborn care.

Applications will be evaluated on the uniqueness and feasibility of the idea, the thoroughness of the approach, the identification of key resources and plan to further the idea and the idea’s potential to profoundly change human health outcomes. Applications must be submitted by practicing or retired nurses. The deadline to apply for the Johnson & Johnson Nurses Innovate QuickFire Challenge in Perioperative Care is July 26, 2019 midnight PST and the deadline to apply for the Nurses Innovate QuickFire Challenge in Maternal and Newborn Health is October 10, 2019 midnight PST. Learn more about the QuickFire Challenges and apply here .

[1] Jacobson, J., Mulick, J., & Green, G. (1998). Cost-benefit estimates for early intensive behavioral intervention for young children with autism - General model and single state case. Behavioral Interventions, 13(4), 201-226. Retrieved from https://www.researchgate.net/publication/237347058_Cost-benefit_estimates_for_early_intensive_behavioral_intervention_for_young_children_with_autism_-_General_model_and_single_state_case.
[2] Jacobson, J., Mulick, J., & Green, G. (1998). Cost-benefit estimates for early intensive behavioral intervention for young children with autism - General model and single state case. Behavioral Interventions, 13(4), 201-226. Retrieved from https://www.researchgate.net/publication/237347058_Cost-benefit_estimates_for_early_intensive_behavioral_intervention_for_young_children_with_autism_-_General_model_and_single_state_case.
[3] CDC/NCHS. (2012). Data Brief 97: Diagnostic History and Treatment of School-aged Children with Autism Spectrum Disorder and Special Health Care Needs. Survey of Pathways to Diagnosis and Services, 2011. Retrieved from https://www.cdc.gov/nchs/data/databriefs/db97_tables.pdf.
[4] David G. Armstrong, D.P.M., M.D., Ph.D., Andrew J.M. Boulton, M.D., and SiccoA. Bus, Ph.D. 2017. Diabetic Foot Ulcers and Their Recurrence. New England Journal of Medicine 376:24.

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